CASE STUDY
JOSE VLADIMIR ALVEAR CHAVARRO COD:192075
During the physical examination of a 12 year old girl, a Young physician was unable to detect a
heartbeat. The radial pulse, however, was normal. After considerable thought, the physician was
able to detect a normal heartbeat
Clinicoanatomical Problems
1. Where would the physician normally attempt to listen to the apex beat of the heart?
The doctor would normally try to listen in the patient's auscultation foci, specifically he would
be guided by the mitral auscultation focus located in the fifth intercostal space with the left
clavicular midline and it is where the noises generated by the mitral valve are best heard due
to the position that the left ventricle has the most contact with the costal wall.
2. What congenital anomaly of the heart could account for failure to detect a heartbeat on the
left side of the chest?
The patient presents a dextrocardia which is a malformation that occurs in the embryonic
period and is characterized by the displacement of the mass and the main cardiac axis (the base
of the apex) to the right of the chest, with reversal of the apical inclination, this malformation.
it is generated in the fourth week when the primitive cardiac tube bends to the left.
